OCCUPATIONAL OVERUSE SYNDROME (OOS) FOR THE WRIST STRUCTURE
OOS has been around for a long time and was first noted in the building industry with Form workers. It went largely ignored until the late 80’s when it started to affect large numbers of office workers (predominantly typists and data entry people), being called repetitive strain injury (RSI) at the time. The introduction of touch typing keypads was widely considered to be the cause of its appearance in the office industry.
The introduction of health and safety policies prescribing taking regular breaks and doing movement exercises was effective at managing the problem.
With a change in office set ups from data entry sections to individuals having their own computers and managing their own data entry, OOS became far less frequent. Unfortunately the introduction of call centers and a push to paperless offices in the mid 90’s saw a resurgence in the presentation of OOS. Many offices encourage taking regular breaks; Few enforce it; Fewer enforce doing movement exercises.
The use of hand held devices, laptops etc in the modern era has seen a spike in OOS of both the wrist and thumb structures throughout a wide spectrum of society. With under 20’s being seriously affected for the first time.
What is OOS?
OOS is caused by constant repetitive movements of the hand. When this occurs the shoulder, upper back and neck muscles that support the weight of the arms are put under stress. As these muscles fatigue their ability to support the weight of the arms decreases. This causes an increase in load to the wrist and elbow structures. These structures are not designed to maintain this load and will develop injury pathologies as a result. The wrist is most commonly affected. OOS in the elbow is more commonly seen as a result of activities such as golf and tennis.
There are 3 common pathologies associated with OOS
1. Tenosynovitis
Inflammation of the tendon sheath and the synovial membrane of the joint structure. Pain is often associated with applying direct pressure to the area. Movement may become restricted and painful.
2. Tendonitis
A strain of a tendon. Constant pain and fatigue with restricted movement is common. Varying amounts of inflammation may occur.
3. Carpal Tunnel Syndrome
Compression of the median nerve inside the carpal tunnel of the wrist. Constant pain, sever fatigue and restricted movement is common.
Treatment
1.The best treatment is prevention.
Taking regular breaks, 1 per hour for 5 minutes, and doing simple stretches and movement exercise’s will minimize the risk of developing OOS in most industries for most people. When you move your arms in different directions it causes the muscles to change the way they contract and the joints to be more mobile. This decreases their risk of fatigue.
2. If occurring in the work place, notification (incident report) to the appropriate authority is the first step. Workplace assessment and referral to medical professional will establish treatment protocol.
3. Physical Therapy:
Treating OOS is two fold.
(a) Hands on treatment of the neck, upper back, shoulder and arm.
(b) Rehabilitation exercises to regain normal muscle function and range of movement.
General Aids: Anti-inflammatory cream; Ice packs (15 minutes on, 2 hours off); Supports.
Surgery: Current surgical procedures are minimally invasive and generally have a high % outcome.
Contact Chevron Island Physio for more information and to see how we can help you! 5504 7000
By Simon Ayling
Chevron Island Physio
